CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: South Miami Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $3,136
Cash Discount Price: $4,479
vs. Medicare Baseline: 17.50x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at South Miami Hospital is $3,136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,479. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 17.50x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.

Cash / Self-Pay

$4,479

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,136

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)

Cash / Self-Pay: $4,479 (2499%)

Insurance Median: $3,136 (1750%)

Cash: $4,479 (2499% of Medicare)

Ins. Median: $3,136 (1750% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1750% of the Medicare baseline (a markup of 1650%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicare (plans)	$183 - $247	102%
Blue Cross Blue Shield	$190 - $4,607	106%
Medica Health Plan	$196	109%
Amerigroup	$197	110%
Medicaid / KanCare	$197 - $217	110%
Humana	$200	112%
Avmed	$201 - $3,519	112%
Leon Medical	$201	112%
Aetna	$205 - $5,688	114%
UnitedHealthcare	$207 - $7,110	116%
Wellcare	$207	116%
Cigna	$209 - $5,688	117%
Sunshine State	$209	117%
Vista	$213	119%
Non Contracted	$2,448 - $2,609	1366%
Amerihealth	$3,002 - $3,200	1675%
International	$4,336 - $4,622	2420%
Dimension Health Plan	$5,002 - $6,399	2791%
Affordable	$5,670 - $6,044	3164%
Phcs	$6,003 - $6,399	3350%
Quality Health	$6,003 - $6,399	3350%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $4,479.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm South Miami Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.